Paced Bottle Feeding
Updated: Oct 29, 2019
When you turn a bottle upside down and watch the liquid come out out what do you see? Typically a very constant drip or consistent flow of milk. When we drink we having a constant flow can be challenging because we need time to swallow and breathe.
Some babies are very good at pacing themselves and you will see them take a break every three to four sucks for a swallow however some babies cannot do this independently. These babies may struggle with bottle-feedings because they are having difficulty coordinating a suck-swallow-breathe pattern on their own.
Signs that they are having difficulty include coughing and/or choking, gasping for breath, eye widening, and/or loud swallows heard during feeding. Others include bottle refusal, milk spilling out the sides as well as feedings taking longer than 30 minutes. When this occurs, the use of paced feedings (also called external pacing) may be helpful. By managing the flow of the liquid and inserting brief pauses in sucking, you can help your baby become more coordinated and efficient with the bottle.
How it looks:
Position your baby in a more upright position ensuring that their head, neck, and trunk are aligned and well supported.
Present the bottle in a horizontal position (perpendicular to the baby’s mouth) naturally slowing the flow of liquid.
Allow the baby to open her mouth and accept the nipple, never forcing it in.
Watch as the baby begins to suck, allow her to suck 3-5 times and tilt the bottle downward or remove the nipple if she has not paused to breathe.
Often babies will swallow, take a breath, and open their mouth to let the feeder know they are ready to begin feeding again.
Continue this process throughout the first few minutes of the feeding. You may notice that the baby begins to naturally pace themselves (this is good, this is your goal! ) and you will not have to tilt the bottle as much and eventually not at all.
Use a slow flow nipple to start with to naturally slow the flow of fluid.
Try feeding your baby in an elevated side-lying position to help keep the bottle in a neutral position and the baby more organized.
Try sitting with your legs crossed and allow the baby to rest naturally in your leg so they are fully supported.
Remember to always follow your baby's lead. If they are refusing the bottle, they are not ready for a feeding. We never want to force a baby to eat.
Download our Paced Bottle Feeding tip sheet here - this is a great resource to share with family members and caregivers who may be feeding your baby!
*This information is not to replace medical or professional advice. If you feel that your baby is still struggling with feedings, please seek support from a local speech pathologist or occupational therapist.